Comments on: The Case of the Missing Evidence http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/ Self-Experimentation, Scientific Method, the Shangri-La Diet, etc. Fri, 19 Mar 2010 07:59:11 +0000 http://wordpress.org/?v=2.0.7 by: Noumenon http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-335261 Sat, 22 Aug 2009 08:37:02 +0000 http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-335261 FWIW when I had my visible hernia that didn't hurt my doctor here in rural Wisconsin said he'd never seen one he couldn't push back in so I might as well wait for it to incarcerate before I got the surgery. But I eventually got the surgery anyway, and now a nerve in my hip burns when I get tired. FWIW when I had my visible hernia that didn’t hurt my doctor here in rural Wisconsin said he’d never seen one he couldn’t push back in so I might as well wait for it to incarcerate before I got the surgery. But I eventually got the surgery anyway, and now a nerve in my hip burns when I get tired.

]]> by: Seth’s blog » Blog Archive » Jane Jacobs and the Trouble with Medicine http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-330270 Sat, 08 Aug 2009 11:48:14 +0000 http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-330270 [...] Are doctors takers or traders? The flaw in trying to improve doctor performance by changing incentives is the balance of power: Doctors have almost all of it. Patients trust doctors. (When I asked my surgeon the basis for her judgment that I needed surgery — treating her as an equal, in other words — she must have been stunned. She certainly didn’t respond appropriately.) That’s why it’s so easy for doctors to do too much or too little. It’s the same problem with quota systems for policemen: The policemen have too much power. The current balance of power makes doctors takers rather than traders. [...] […] Are doctors takers or traders? The flaw in trying to improve doctor performance by changing incentives is the balance of power: Doctors have almost all of it. Patients trust doctors. (When I asked my surgeon the basis for her judgment that I needed surgery — treating her as an equal, in other words — she must have been stunned. She certainly didn’t respond appropriately.) That’s why it’s so easy for doctors to do too much or too little. It’s the same problem with quota systems for policemen: The policemen have too much power. The current balance of power makes doctors takers rather than traders. […]

]]> by: Stephen M (Ethesis) http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-268638 Sat, 07 Feb 2009 04:13:33 +0000 http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-268638 "There’s a subbranch of the field of folklore" ... reminds me of the stories of mice in soft drink bottles ... and reading about how that was all folklore, except, of course, I had seen the citations and the actual case law involving those cases on appeal. Or, in a case closer to home, the actual maggots in the package of crackers I went out and bought my wife when she was pregnant. On a different example, which I will skip the details, you can imagine my surprise at having worked on a case and then having read about it being urban folklore. Since the law suit involved someone suing over the facts being disclosed ... I rather believed the facts were acknowledged, not folklore. Pleadings at the county courthouse. Just a comment. “There’s a subbranch of the field of folklore” … reminds me of the stories of mice in soft drink bottles … and reading about how that was all folklore, except, of course, I had seen the citations and the actual case law involving those cases on appeal.

Or, in a case closer to home, the actual maggots in the package of crackers I went out and bought my wife when she was pregnant.

On a different example, which I will skip the details, you can imagine my surprise at having worked on a case and then having read about it being urban folklore. Since the law suit involved someone suing over the facts being disclosed … I rather believed the facts were acknowledged, not folklore. Pleadings at the county courthouse.

Just a comment.

]]> by: retired urologist http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-267344 Wed, 04 Feb 2009 02:42:49 +0000 http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-267344 See comment on your post Feb 1, 2009. See comment on your post Feb 1, 2009.

]]> by: seth http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-266735 Mon, 02 Feb 2009 06:19:08 +0000 http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-266735 "give evidence"? I guess you mean give more evidence. Doctors' widespread disinterest in evidence is the subject of my latest post. I would be interested in your thoughts on the subject. “give evidence”? I guess you mean give more evidence. Doctors’ widespread disinterest in evidence is the subject of my latest post. I would be interested in your thoughts on the subject.

]]> by: retired urologist http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-261554 Tue, 20 Jan 2009 16:05:15 +0000 http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-261554 Mark, Thanks for re-opening this discussion. If it did not involve a world-class thinker who states in his widely-read <a href="http://www.overcomingbias.com/welcome.html" rel="nofollow">blog</a> that his significant interest is "the rationality of paternalism and other kinds of disagreement", and who makes a living teaching medical economics, perhaps it would have no importance, and bear no further attention. However, a clear thinker like Seth Roberts has said that the incident was "the most telling detail in Robin Hanson’s lecture about doctors", the result being that he "was very impressed by Robin’s lecture". Consequently, I continue to feel that it should be fleshed out for what it is. I tried <a href="http://drchip.wordpress.com/2008/10/04/disagreements/" rel="nofollow">here</a> and <a href="http://drchip.wordpress.com/2008/10/05/bias-on-the-hoof-hanson-and-ru-continued/" rel="nofollow">here</a> to get Hanson to reconsider the matter or give evidence, but he would not (see his comments, and judge for yourself). Mark,
Thanks for re-opening this discussion. If it did not involve a world-class thinker who states in his widely-read blog that his significant interest is “the rationality of paternalism and other kinds of disagreement”, and who makes a living teaching medical economics, perhaps it would have no importance, and bear no further attention. However, a clear thinker like Seth Roberts has said that the incident was “the most telling detail in Robin Hanson’s lecture about doctors”, the result being that he “was very impressed by Robin’s lecture”. Consequently, I continue to feel that it should be fleshed out for what it is. I tried here and here to get Hanson to reconsider the matter or give evidence, but he would not (see his comments, and judge for yourself).

]]> by: Mark http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-261240 Tue, 20 Jan 2009 03:49:46 +0000 http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-261240 "Mark, Robin’s wife did not hear a story about someone else being fired — she heard from the person who was fired." Yes, FOAF would seem to imply that these stories are two levels away, but many people will move the level up one. It's just an unconscious need to make the story more immediate and vivid and place oneself at the center of the action. In the case of my workmate, his mother knew the person supposedly involved. Now I didn't contact her and ask her about it, but the story (involving a person who fainted from cut-off circulation due to some sort of device in his pants to make it appear that he had larger genitals than he really did) was a classic piece of emergency room lore described by Brunvand. Mind you, I'm not saying that anyone at all is lying. It's just that people's minds play tricks. This is the entire basis of the study of folklore, and not only anthopologists, but many journalists have run across this phenomenon. And I'm not saying that such a study, if actually done, would not turn up the results claimed. It's just that the particular details and person involved are unconscously fabricated. Why don't you try to actually contact the nurse involved. If it's really just one person away, it shouldn't take much time. And if she was fired, she has nothing to lose and shouldn't mind speaking to you. Make sure to get back to us with your results. ;-) The way I see this is that at some point some medical professional hypothesized to another that if such a study were done such a result would ensue. Then a couple of people down the line, the story became that the study actually was done. Then at some point in passing this fable along, someone made the crack that, yeah, and the nurse would probably get fired for her trouble. And a few levels away from that it wasn't a crack but a fact. And the urban legend went on from there, each time with a little more certainty added to it. (By the way, an excess of details that anticipate objections are one characteristic of urban legends.) The comments to this post show how much interest there is in the medical community about the issues raised by the story. Urban legends flourish the most when they "confirm" the opinions of large numbers of people in the community in which they are passed on. “Mark, Robin’s wife did not hear a story about someone else being fired — she heard from the person who was fired.”

Yes, FOAF would seem to imply that these stories are two levels away, but many people will move the level up one. It’s just an unconscious need to make the story more immediate and vivid and place oneself at the center of the action.

In the case of my workmate, his mother knew the person supposedly involved. Now I didn’t contact her and ask her about it, but the story (involving a person who fainted from cut-off circulation due to some sort of device in his pants to make it appear that he had larger genitals than he really did) was a classic piece of emergency room lore described by Brunvand.

Mind you, I’m not saying that anyone at all is lying. It’s just that people’s minds play tricks. This is the entire basis of the study of folklore, and not only anthopologists, but many journalists have run across this phenomenon. And I’m not saying that such a study, if actually done, would not turn up the results claimed. It’s just that the particular details and person involved are unconscously fabricated.

Why don’t you try to actually contact the nurse involved. If it’s really just one person away, it shouldn’t take much time. And if she was fired, she has nothing to lose and shouldn’t mind speaking to you. Make sure to get back to us with your results. ;-)

The way I see this is that at some point some medical professional hypothesized to another that if such a study were done such a result would ensue. Then a couple of people down the line, the story became that the study actually was done. Then at some point in passing this fable along, someone made the crack that, yeah, and the nurse would probably get fired for her trouble. And a few levels away from that it wasn’t a crack but a fact. And the urban legend went on from there, each time with a little more certainty added to it. (By the way, an excess of details that anticipate objections are one characteristic of urban legends.)

The comments to this post show how much interest there is in the medical community about the issues raised by the story. Urban legends flourish the most when they “confirm” the opinions of large numbers of people in the community in which they are passed on.

]]> by: Bias on the hoof: Hanson and RU continued « It’s Not Hard… but it could be http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-224465 Sun, 05 Oct 2008 23:44:45 +0000 http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-224465 [...] A reader (not me) saw coverage of the post on the blog of Seth Roberts, and asked Hanson “whether you actually ever met and talked to the fired nurse, how strong her evidence was that she was fired for the reason in the story, etc.? Did your wife actually know her, or know someone who knows her (who might turn out to be someone who knows someone who knows someone), that sort of thing? ” Hanson replied: “ the nurse was a close co-worker of my wife, who I’ve met.” (Nothing more.)   [...] […] A reader (not me) saw coverage of the post on the blog of Seth Roberts, and asked Hanson “whether you actually ever met and talked to the fired nurse, how strong her evidence was that she was fired for the reason in the story, etc.? Did your wife actually know her, or know someone who knows her (who might turn out to be someone who knows someone who knows someone), that sort of thing? ” Hanson replied: “ the nurse was a close co-worker of my wife, who I’ve met.” (Nothing more.)   […]

]]> by: retired urologist http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-221808 Mon, 22 Sep 2008 18:01:18 +0000 http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-221808 agreed agreed

]]> by: J Thomas http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-221797 Mon, 22 Sep 2008 16:24:19 +0000 http://www.blog.sethroberts.net/2008/09/13/the-case-of-the-missing-evidence/#comment-221797 RU, the cost for medical care plus insurance overhead etc is something like 16% of GDP and rising. It's already more than we can afford. I can't expect MDs to do anything that might reduce their guild; privileges, but it's plausible that insurance companies and government might want things to reduce expense. That could include public health measures and improved self-screening approaches. My father is a retired dentist. Back when fluoridation was new he campaigned heavily for it. Some other dentists said that he shouldn't because he'd be cutting back on business. "Cutting his own throat." But he argued that there would be plenty of dental business even after fluoridation, and he was right. Currently, more things to make people ill won't increase medical payments much. The money just isn't there. RU, the cost for medical care plus insurance overhead etc is something like 16% of GDP and rising. It’s already more than we can afford.

I can’t expect MDs to do anything that might reduce their guild; privileges, but it’s plausible that insurance companies and government might want things to reduce expense. That could include public health measures and improved self-screening approaches.

My father is a retired dentist. Back when fluoridation was new he campaigned heavily for it. Some other dentists said that he shouldn’t because he’d be cutting back on business. “Cutting his own throat.” But he argued that there would be plenty of dental business even after fluoridation, and he was right.

Currently, more things to make people ill won’t increase medical payments much. The money just isn’t there.

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